Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.

Acne is a common skin problem seen in primary care. Dr Wong
Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore
shares his insights with Pearl Toh on how to manage acne in the primary care
setting.

Syncope complicates immediate-risk pulmonary emboli

18 Mar 2020

Syncope signals a more complicated in-hospital disease course in patients with immediate-risk pulmonary emboli (PE) with right ventricular (RV) involvement, reports a new study.

Researchers conducted a retrospective analysis of 212 patients (mean age, 65.1±16 years; 56 percent female) with normotensive PE, with slight evidence of RV involvement. Outcomes included major adverse clinical events (MACEs), described as one or a combination of mechanical ventilation, the need for reperfusion therapy and haemodynamic instability. In-hospital mortality was also identified as a study endpoint.

The in-hospital course of disease was significantly more complicated in participants who presented with syncope. MACEs, for example, occurred around thrice as much than in patients without syncope (29 percent vs 9.4 percent; p=0.003). This was confirmed through multivariate analysis, adjusting for potential confounders (odds ratio, 3.8, 95 percent confidence interval, 1.48–9.76; p=0.005).

Such an outcome was driven by a significantly greater need for inotropic support (10 percent vs 0.6 percent; p=0.005) and mechanical ventilation (10 percent vs 1.8 percent; p=0.03), as well as by a higher incidence of haemodynamic instability (18 percent vs 3 percent; p=0.02).

Bleeding also occurred more commonly in those with syncope (15 percent vs 2.4 percent; p=0.004), while rates of in-hospital and 90-day mortality were comparable between groups.

Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.

Acne is a common skin problem seen in primary care. Dr Wong
Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore
shares his insights with Pearl Toh on how to manage acne in the primary care
setting.